A chest that hurts when a person coughs is relatively common. It is not usually a cause for concern unless it is persistent or severe.

In many cases, the pain goes away on its own as the infection clears. However, chest pain can sometimes signal a serious chest infection, such as pneumonia, so it is important to see a doctor for chest pain when coughing.

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Causes of chest pain when coughing may include muscle exhaustion, pleurisy, and asthma.

Chest pain with a cough comes in many forms. The pain may be stabbing or throbbing, and it can range from very mild to unbearable.

When there are other symptoms, especially fever or trouble breathing, this may indicate a serious underlying infection. Some other symptoms that a person might notice include:

  • muscle aches and pains
  • low energy or fatigue
  • coughing up mucus
  • wheezing or trouble breathing

The possible causes of chest pain when coughing include:

Muscle exhaustion

A person uses many muscles in the chest, back, and abdomen when they cough. An intense cough or many days of coughing can exhaust these muscles, making them feel sore or painful, especially when a person massages the affected area.

The pain usually peaks during a cough and then gets better between coughs.

It can be difficult to distinguish muscle pain from other types of pain, such as the pain of an inflamed lung. Therefore, if a person is uncertain about the origin of the pain, it is wise to see a doctor.

Pneumonia

Pneumonia is a common but potentially dangerous lung infection. Viruses, bacteria, and even fungi or parasites can cause pneumonia. In some people, viral pneumonia develops after a cold or the flu.

Healthy people usually recover from pneumonia with routine treatment. However, this infection can potentially be fatal in older adults, infants, and people with a weakened immune system.

Some symptoms of pneumonia include:

  • sharp, stabbing chest pain when coughing
  • a high fever
  • chills
  • feeling very unwell
  • nausea and vomiting in children
  • confusion in elderly people
  • shallow or rapid breathing
  • shortness of breath
  • a low oxygen level

Pleurisy

Pleurisy is inflammation of the pleural tissue, which covers the outside of the lungs and the inside of the chest wall. People with pleurisy may also develop fluid in between layers of pleural tissue.

Pleurisy is a possible complication of pneumonia, although other infections and noninfectious conditions can cause this potentially life threatening disorder.

Symptoms include:

  • trouble breathing
  • feeling as though not enough air is entering the body
  • painful breathing
  • fever
  • shortness of breath
  • chest pain that gets worse when coughing

Bronchitis

Bronchitis causes inflammation and swelling in the bronchial tubes, which connect the throat to the lungs. This inflammation makes it more difficult to breathe and can cause chest pain and pressure.

Although bronchitis can sometimes be a chronic disease, many people experience it as an acute, short-term infection. In many cases, bronchitis comes during or after a cold or the flu.

Some symptoms of bronchitis include:

  • coughing up mucus
  • soreness or pain in the chest
  • a sore throat
  • a headache
  • body aches
  • sometimes, a fever

COPD

Chronic obstructive pulmonary disease (COPD) refers to a group of conditions, including chronic bronchitis and emphysema, that cause inflamed, swollen, and obstructed airways. The disease is progressive, which means that it gets worse over time.

The main symptoms are chest pain and a cough. Some people also notice:

  • shortness of breath
  • trouble breathing
  • wheezing
  • low energy
  • mucus buildup

Asthma

Asthma causes inflamed and narrowed airways. Certain triggers can suddenly increase the inflammation and swelling, making it difficult to breathe. People refer to this as an asthma attack.

During an asthma attack, a person may have trouble breathing or catching their breath. They may hear themselves wheezing or feel tightness in their chest. Some people also have chest pain during or following an asthma attack.

Learn what to do at home for an asthma attack.

Cancer

Some people with chest pain and a cough may worry about lung cancer, especially if the symptoms are chronic and do not appear to be due to an infection, such as a cold or the flu.

Lung cancer can cause chest pain when coughing, but most people also experience other symptoms, including:

  • unexplained weight loss
  • fatigue
  • shortness of breath
  • hoarseness
  • wheezing
  • loss of appetite
  • feeling weak

Mild chest pain from muscle fatigue usually goes away on its own.

However, a serious chest infection can be life threatening without treatment. Some potential complications include:

  • sepsis, a systemic inflammatory state that occurs as a result of significant infection and can cause organ failure
  • myocarditis, an inflammation of the heart that sometimes occurs with the flu or other viral infections
  • respiratory failure, which happens when the lungs become so damaged that a person cannot breathe
  • kidney failure

If a person has a weakened immune system or underlying health conditions, or is an older adult or an infant, an untreated chest infection can potentially be lethal.

To diagnose the cause of chest pain, a doctor may:

  • take a comprehensive medical history, asking about recent symptoms and any chronic conditions, as well as family history
  • examine the person and listen to their lungs
  • do bloodwork to check for signs of inflammation, including that resulting from infection
  • order imaging tests of the lungs and chest, such as a chest X-ray
  • recommend a lung biopsy if a CT scan or X-ray shows a nodule or other growth in the lungs

The right treatment for chest pain when coughing depends on the cause. When a person has a mild cold, a doctor may recommend rest and fluids. Some other home remedies can help with viral illnesses, such as the flu, bronchitis, and even mild pneumonia. A person can try:

  • using over-the-counter pain relieving medication to control pain and fever
  • taking steam baths to loosen mucus in the chest
  • avoiding going to work or school until symptoms have disappeared
  • drinking warm or hot drinks
  • avoiding smoke and pollution
  • getting plenty of rest
  • using a humidifier when sleeping

If the chest infection is bacterial, a doctor will generally prescribe antibiotic therapy.

Severe chest infections may require a person to stay in the hospital, where they can get intravenous fluid or medications, supplemental oxygen, and nebulized breathing treatments.

Some other treatments that a doctor might recommend include:

  • a corticosteroid to decrease inflammation, speed healing, and help with coughing, especially if a person has pleurisy, a COPD flare, or severe bronchitis
  • various procedures to drain the pleural cavity of fluid
  • surgery to treat lung problems such as cancer or an abscess

COPD is incurable, but treatment can help manage symptoms and prolong life. A doctor may prescribe corticosteroids, bronchodilators (which help dilate the small airways), a type of training called pulmonary rehabilitation, or surgery.

People with lung cancer may need chemotherapy, radiation, or surgery.

A person with mild chest pain can usually wait a few days to see a doctor. If the person has symptoms that do not improve within a few days, is an older adult or an infant, or has a respiratory condition, it is best to see a doctor immediately, even if the symptoms are not severe.

A person should also see a doctor if they have:

  • mild symptoms that become severe
  • symptoms that persist or worsen despite taking prescription treatment
  • a high fever
  • difficulty breathing
  • feelings of nausea or extreme fatigue
  • a high risk of pneumonia — for example, people with dementia, COPD, lung cancer, or a weakened immune system — and develop a high fever, cough, chest pain, or other symptoms of pneumonia
  • sudden behavioral changes, including new confusion or loss of skills, such as using the toilet without help

Emergency treatment is necessary if:

  • a newborn or older adult develops a high fever
  • a person cannot breathe or catch their breath
  • a person seems newly confused or has other acute behavioral changes
  • a person has symptoms that warrant a visit to the doctor but cannot get in touch with their doctor

Factors that affect the outlook of a person experiencing chest pain when coughing include:

  • whether the person has a chest infection and how severe it is
  • the person’s age
  • the person’s overall health

Seeing a doctor is essential for ensuring the successful diagnosis and treatment of chest pain when coughing.